In this issue, we highlight October 10th, National Face Your Fears Day & World Mental Health Day. With this in mind, I have selected a topic about the identification and treatment of phobias. “Fear is a powerful emotion, one that immobilizes, traps words in our throats, and stills our tongues” (Sue & Sue, 2015, p. 299). I would like to differentiate fear from anxiety. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), “fear is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat” (APA, 2013, p. 189).

Phobia: What it is and What it is Not. 

It is normal and common for individuals to experience anxiety and fear, from time to time. Nevertheless, most individuals have adaptive coping mechanisms and techniques to combat and confront their everyday fears. What can be distressing, is when we experience unreasonable or exaggerated responses to threats, and we stop engaging with the world. Consequently, we experience “severe anxiety,” and catastrophizing thoughts, in lieu of “reasonable anxiety.” Simply put, we envision the worst case outcome. Further, an exaggerated fear can produce, in addition to feelings of anxiety and disproportionate fear response(s), some augmented physiological responses, such as sweating, trembling, and increased heart rate (Dessai, 2016).

Etiology and Causes

The causes of phobias are unknown. Some literature points to hereditary factors, that is, someone in your family may share a similar fear (Dessai, 2016). Specific phobias could be linked to a traumatic event you have experienced (APA, 2013). They could also be attributed to observing another individual experiencing a traumatic event. Further, they could result due to prolonged or extensive media coverage of a distressing event. Specific phobias typically develop in early childhood, with more than half of the cases developing prior to 10 years of age (APA, 2013). Below you will find a concrete example. Perhaps, after recounting a story that you were attacked by a dog as a young child, you realize that you have an extreme fear of dogs, known as cynophobia.

What is a phobia?

A phobia is the most extreme type of irrational fear of an object or situation, as cued by a phobic stimulus (APA, 2013). It causes individuals to go to great lengths to avoid any perceived danger (Dessai, 2016). In the United States, according to the DSM-5, specific phobias have a prevalence rate of 7 – 9% of the population, (APA, 2013). Phobias interfere with an individual’s daily routine, work, relationships, and social life (APA, 2013).

What are some common fears or phobias?

Fears can run the gamut in form and nature. Some fears include, pyrophobia (fear of fire), alektorophobia (fear of chickens), triskaidekaphobia (fear of the number 3), pinaciphobia (fear or avoidance of lists) (Dessai, 2016). There are many other phobias that take different forms too. Please see https://www.verywellmind.com/list-of-phobias-2795453, for a list of common phobias (Cherry, 2023). 

Types of phobia

There are three types of phobias. The first type includes specific phobias. The second type of phobia involves agoraphobia or fear of public places. In this context, an individual may avoid being in a large communal area (e.g., parade, mall, theater), where it is difficult to escape quickly and retreat to safety (i.e., one’s home). The third type of phobia is called social phobia. When someone is fearful of social situations, they may exhibit intense feelings of embarrassment or judgment, on the perceived part of others. This type of social anxiety may inadvertently cause someone to experience anxiety for weeks leading up to a social event. Another manifestation of social anxiety could present as being afraid to eat in front of other people (Dessai, 2016).

Specific phobias fall into five categories

Specific phobias can fall into five different categories of groups. The first includes a fear of animals. The second includes fear of blood and needles. For example, hemophobia is a fear of blood. The third one includes a fear of one’s natural environment. An example could be fear of the dark. The fourth category is situational. For example, someone who has a fear of flying could be experiencing aviophobia. The last category is “other” and relates to any other elements, such as a fear of clowns, which is called coulrophobia (Dessai, 2016).

Treatments: I have a phobia, so what can I do about it?

Depending on the individual, as we are all unique, the treatment can take several forms. Other considerations, to take into account, is one’s comorbidity (multiple psychological disorders occurring simultaneously), and medication or substance use (Dessai, 2016). The most common effective psychotherapy intervention, to confront phobias, is Cognitive-Behavioral Therapy (CBT) (Ipser, 2013). Mindfulness, a third-wave form of CBT, can also be practiced. Discuss your fears, irrational, and automatic thoughts with your psychotherapist. In most cases, the likelihood that your worst fear will be realized is low (Dessai, 2016). 

Moreover, systematic desensitization is a process whereby gradually and systematically, an individual is exposed to a fearful object, event, or situation. The most important element to begin with is to clearly identify and define your fear. Then with the support of psychotherapy, an individual can learn coping mechanisms to confront such fear. With time, the individual may engage the learned technique, or substitute an adaptive replacement cognition/behavior, into daily practice (Dessai, 2016; Cherry, 2023). I hope you found this topic enlightening, and that it may be supportive of any current phobia you may be experiencing.

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Ed.).

Cherry, K. (2023, February 13). List of Phobias: Common Phobias From A to Z. Very Well Mind. Retrieved from https://www.verywellmind.com/list-of-phobias-2795453.

Ipser, J. C., Singh, L., & Stein, D. J. (2013). Meta‐analysis of functional brain imaging in specific phobia. Psychiatry and clinical neurosciences, 67(5), 311-322.

Sessai, R. (2016). Phobias. Retrieved from https://www.youtube.com/watch?v=PCOg2G797ek

Sue, D. W., & Sue, D. (2015). Counseling the culturally diverse: Theory and practice (7th Ed.). Wiley & Sons.